

Dr. Hossein Adlkhoo is a distinguished anesthesiologist and pain medicine subspecialist based in Tehran. With advanced training in the United […]
Cervical stenosis refers to the pathological narrowing of the spinal canal in the cervical spine (C1-C7 vertebrae). This constriction can compress both the spinal cord (myelopathy) and nerve roots (radiculopathy), potentially causing significant neurological deficits.
Degenerative changes (most common):
Spondylosis (spinal osteoarthritis)
Hypertrophic facet joints
Ligamentum flavum thickening
Congenital factors:
Naturally narrow spinal canal
Genetic predisposition
Other causes:
Herniated discs
Spinal trauma
Post-surgical changes
Ossification of posterior longitudinal ligament (OPLL)
Neurological Symptoms:
Radicular symptoms (nerve root compression):
Sharp, radiating arm pain
Paresthesia in dermatomal patterns
Muscle weakness in specific myotomes
Myelopathic symptoms (cord compression):
Hand clumsiness (loss of fine motor skills)
Gait disturbances
Hyperreflexia
Potential bowel/bladder dysfunction (late stage)
Pain Characteristics:
Chronic neck pain/stiffness
Headaches (occipital region)
Aggravation with neck extension
Imaging:
MRI (gold standard for soft tissue evaluation)
CT myelography (for surgical planning)
Dynamic X-rays (assessing instability)
Electrodiagnostics:
EMG/NCS (differential diagnosis)
Clinical Assessment:
Spurling’s test
Hoffman’s sign
Lhermitte’s phenomenon
Conservative Treatment:
Physical therapy (cervical stabilization)
Medications:
NSAIDs
Neuropathic agents (gabapentin/pregabalin)
Epidural steroid injections
Cervical collar (limited use)
Surgical Indications:
Progressive neurological deficits
Refractory pain
Myelopathic symptoms
Significant cord compression on imaging
Anterior Approach:
ACDF (anterior cervical discectomy & fusion)
Corpectomy (for multi-level involvement)
Posterior Approach:
Laminectomy
Laminoplasty (motion-preserving)
Combined Approaches (for complex cases)
Early intervention improves outcomes
70-80% success rate with appropriate surgery
Physical therapy crucial for post-op recovery
Regular follow-up for adjacent segment disease
Maintain neck muscle strength
Ergonomic workplace adjustments
Regular physical activity
Smoking cessation (accelerates degeneration)
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